Intracerebral steal phenomenon in a case of the caortid occlusion

Abstract

A case of the occlusion of the cervical internal carotid artery associated with intracerebral steal phenomenon is reported.
A forty-five year old man was admitted complaining of hearing disturbance and tinnitus on the left side. He had twice episode of general convulsion following Jacksonian marching. Computed tomography disclosed no significant finding. Angiograms revealed complete occlusion of the right internal carotid artery (ICA) at the cervical portion. The vertebral angiogram showed the filling of the right internal carotid territory bia posterior communicating artery with the filling of the vertebr-basilar territory.
We concluded that these auditory symptoms had been caused by the intracerbral steal mechanism between the right ICA and the vertebro-basilar territory. The extracranial-intracranial bypass was performed on the right side. Soon after the operation auditory symptoms were significantly improved. Postoperative angiograms indicated the enough filling of the right internal carotid territory from the right superficial temporal artery. After the discharge, the former auditory symptoms were complained again because of the compression for the donor artery with the frame of the glasses. The release of the compression improved those symptoms.
According to these results we believed that his auditory symptoms caused by the intracerebral steal phenomemon between the internal carotid territory and vertebro-basilar territory.
Hearing disturbance and tinnitus are popular symptoms. They may be thought as an important clue of the cerebrovascular disorders.